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Meconium Ileus 403

Key Summary Points
1. Meconium ileus is very rare in Africa. 5. The treatment of uncomplicated cases is nonoperative by
gastrografin enema.
2. Among Caucasians, 75% of meconium ileus is associated with
cystic fibrosis. 6. In complicated and failed nonoperative treatment cases,
operative intervention is required.
3. A rare variant of meconium ileus not associated with cystic
fibrosis has been described in premature very low birth weight 7. The prognosis of children with meconium ileus has improved
babies. with advances in supportive care in the developed countries.
4. The patients present as uncomplicated or complicated
meconium ileus.

References

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2. Nandi B, Mungongo C, Lakhoo L. A comparison of neonatal 8. Emil S. Meconium obstruction in the very low birth weight
surgical admissions between two linked surgical departments in premature infant. Pediatrics. 2004; 114:1367; author reply, 1367–
Africa and Europe. Pediatr Surg Int 2008; 24:939–942. 1368.
3. Naguib ML, Schrijver I, Gardner P, et al. Cystic fibrosis detection 9. Noblett HR. Treatment of uncomplicated meconium ileus by
in high-risk Egyptian children and CFTR mutation analysis. J Cyst gastrografin enema: a preliminary report. J Pediatr Surg 1969;
Fibros 2007; 6:111–116. 4:190–197.
4. Adeyemi SD. Neonatal intestinal obstruction in a developing 10. Millar AJW, Rode H, Cywes S. Management of uncomplicated
tropical country: patterns, problems, and prognosis. J Trop Pediatr meconium ileus with T tube ileostomy. Arch Dis Child 1988;
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5. Barrack SM, Kyambi JM, Ndungu J, et al. Intestinal atresia and 11. Jawaheer J, Khalil B, Plummer T, et al. Primary resection and
stenosis as seen and treated at Kenyatta National Hospital, anastomosis for complicated meconium ileus: a safe procedure?
Nairobi. East Afr Med J 1993; 70:558–564. Pediatr Surg Int 2007; 23:1091–1093.
6. Mutesa L, Azad AK, Verhaeghe C, et al. Genetic analysis of
Rwandan patients with cystic fibrosis–like symptoms: identification
of novel cystic fibrosis transmembrane conductance regulator
and epithelial sodium channel gene variants. Chest 2009;
135(5):1233–1242. Epub 18 November 2008.